Sleep Problem Linked To Degenerative Brain Disease

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A little-known sleep disorder that causes you to act out your dreams can predict the future onset of Parkinson’s, Alzheimer’s, or another brain disease, new research shows.

In fact, 80 to 90 percent of people who develop Rapid Eye Movement (REM) sleep behavior disorder will develop degenerative brain disease within the near future, says researcher John Peever, MD, associate professor at the University of Toronto.

“Rapid-eye-movement sleep behaviour disorder (RBD) is not just a precursor but also a critical warning sign of neurodegeneration that can lead to brain disease,” says Peever, adding that the sleep disorders should now be considered the “best method of predicting the onset of brain disease.”

Peever’s research, published this week in Trends in Neurosciences, suggests the link occurs because brain degeneration attacks the brain circuits controlling REM sleep before it attacks those areas involved in Parkinson’s, Alzheimer’s, and other neurodegenerative conditions.

How do you know if you have REM sleep behavior disorder? Oh, you’ll know. People with REM sleep behavior disorder act out their dreams, often hitting, kicking, yelling, screaming, or leaping out of bed during the REM phase of sleep.

If you have REMBD, you might find yourself grabbing or punching your sleeping companion (to the point of hurting them), or falling completely out of bed.

And while REMBD (also called REM behavior disorder, and alternatively abbreviated RBD, REMSBD, and REMBD) is often confused with sleepwalking, it’s not the same thing.

The easiest way to tell the difference: sleepwalkers have a hard time waking up, and are groggy and confused when you wake them up. Those with REMBD, on the other hand, pop awake completely alert and conscious of what they were doing. Also, when you sleepwalk you typically don’t remember your dream clearly, while if you have REMBD you usually remember exactly what you were doing and why.

Sleep occurs in five distinct phases, the the fifth of which is REM, the sleep stage in which you’re most likely to dream. REM sleep is also the most active sleep phase, when you may find yourself twitching or tossing. However normally during REM sleep your brain sends a signal temporarily paralyzing your muscles. So even when you dream you’re running away from a criminal, for example, your legs don’t move. However, in people with REM sleep behavior disorder, this paralysis ceases to occur.

REMBD is most common in older men – 90 percent of people who develop it are male, and most are over the age of 50. Scientists already knew REMBD was associated with certain brain disorders, such as Parkinson’s; research has shown that approximately 30 percent of people diagnosed with REMBD will develop Parkinson’s within three years.

However previous studies have not found such an extreme correlation as Peever’s research; 80 to 90 percent is a large percentage.

Once you’re diagnosed with REMBD, the usual treatment is a muscle relaxant such as clonazepam (Clomid or Klonopin). However this new research suggests it’s a good idea for anyone diagnosed with REMBD to have a complete workup for Parkinson’s, Alzheimer’s, dementia, and other brain disorders.

Medications are available for many of these conditions that can delay or slow progression of the disease when taken early enough, so REMBD could serve as an alert to do so.

Explains Peever: “It’s important for clinicians to recognize RBD as a potential indication of brain disease in order to diagnose patients at an earlier stage. This is important because drugs that reduce neurodegeneration could be used in RBD patients to prevent (or protect) them from developing more severe degenerative disorders.”

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